Reviewed by Bronwyn Long, DNP, MBA, RN

What You Need to Know About Opioids

What are opioids?

Opioids are a class of prescription medicine used to treat pain. Common opioid medicines include:

  • Percocet® (oxycodone and acetaminophen)

  • Oxycontin® (long acting oxycodone)

  • Vicoden®, Norco® (hydrocodone and acetaminophen)

  • Morphine

  • Fentanyl

  • Dilaudid® (hydromorphone)

 

Let’s focus on opioids

Opioids may be called painkillers, narcotics or Schedule II controlled substances (CII). The U.S. Food and Drug Administration (FDA) and U.S. Drug Enforcement Administration (DEA) have determined that these medicines carry serious risks of addiction and overdose, often with prolonged use. The government closely monitors and regulates manufacturing, prescribing and dispensing of opioids.

 

When are opioids prescribed?

Opiods are used to treat moderate to severe pain. Pain can be acute or chronic. Acute pain means it will only last a short time (like after surgery). Chronic pain is pain that lasts longer. It occurs with diseases like cancer or arthritis. Opiods are used as a last resort, meaning that other pain medicines and therapy (like physical therapy) are not working.

 

Prescribing restrictions

Because of the risks, only prescribers who have a special license from the DEA can prescribe controlled medicines. Opioids require a new prescription each time they are filled at a pharmacy. Prescriptions for opiods may not be refilled. Many insurance companies place restrictions on the strength of opioids you may receive, how often you may receive them and for how long you may receive them.

 

What is the Colorado PDMP?

Colorado’s Prescription Drug Monitoring Program (PDMP) requires all pharmacies to upload data for opioids and other controlled medicines dispensed to Colorado patients. Pharmacies and providers use this information to make more informed decisions when caring for a patient. Your information will be submitted whenever you fill a prescription for an opioid or other controlled medicine.

 

What are the risks and side effects of opioids?

  • Addiction – means you may develop problems as a result of dependence on the drug

  • Tolerance – means your provider may have to increase your dose over time to get the same level of pain relief

  • Dependence – means your body may have symptoms of withdrawal when you stop the medication

  • Increased sensitivity to pain

  • Severe constipation

  • Nausea, vomiting and dry mouth

  • Confusion, sleepiness and dizziness that could lead to injury

  • Low level of testosterone that can result in lower sex drive, energy and strength

  • Depression

  • Itching and sweating.

 

What can I do to decrease the risks?

  • Take your medicine exactly as instructed. Never take more than prescribed.

  • Take opioid medicine for acute pain only as long as necessary, then stop.

  • Keep your appointments, so your provider can make sure that you are not having any bad side effects and that the medicine is working.

  • Tell your provider all medications you are taking, including vitamins, supplements, over-the-counter medicines and herbal remedies. Let your provider know of any changes to your medicine.

  • Store opioid medicine in a secure place and out of reach of others, including children, friends and family members.

  • Dispose of unused medicine at National Jewish Health’s green medicine collection box, located in the pharmacy waiting area.

  • Be sure you understand the risks of taking opioid medicine and discuss all concerns with your provider.

  • Do not share, sell or trade your prescription opioids. Never use someone else’s medicine. It is dangerous and illegal.

  • Do not drive, operate equipment or make important decisions while taking opioids.

 

Risks of side effects are greater if:

  • You or a family member has a history of drug misuse, substance use disorder or overdose

  • You have been diagnosed with a mental health condition (such as depression or anxiety)

  • You have sleep apnea

  • You are 65 years or older

  • You are or become pregnant.

 

What are the signs of an opioid overdose?

An opioid overdose is extremely dangerous, so take your medicine exactly as prescribed. Even a mild overdose can cause slowed breathing and unresponsiveness. An opioid overdose can kill you. People in Colorado die from prescription opioid overdoses each year.

 

Know your options

Talk to your health care provider about ways to manage your pain that don’t involve prescription opioids. Sometimes these options may work better and have fewer risks and side effects. Options include:

  • Non-opioid pain relievers such as acetaminophen, ibuprofen and naproxen

  • Some medicines used for seizures and depression also help with pain and may have fewer, less serious side effects.

  • Physical therapy and exercise

  • Cognitive behavioral therapy – a therapist can help you learn how to modify your physical, behavioral and emotional triggers of pain and stress.

 

What about refilling my prescription?

  • Opioids require a hand-signed prescription from your provider. Some pharmacies can receive electronic prescriptions sent directly from your provider.

  • Opioid prescriptions cannot be refilled. You must get a new prescription each time you get your medication filled.

  • Call your provider at least three days before you need more medicine. Refills can take several days.

  • If your medicine is stolen, you must file a police report. Bring a copy of the report to your provider. Your insurance company may agree to replace the stolen medicine, usually only once in your lifetime.

 

Can other medicines and foods affect opioid medicine?

Yes, they can.

  • Avoid drinking alcohol while taking prescription opioids.

  • Unless specifically approved by your provider, avoid the following medicines:

    • Benzodiazepines (Such as Xanax® or Valium®)

    • Muscle relaxants (such as Soma or Flexeril)

    • Sleep aids (such as Ambien® or Lunesta®). This includes over-the-counter medicines, too!

    • Other prescription opioids.

 

What about pregnancy and opioids?

Do not take opioid medicine if you are planning to become pregnant or are pregnant. Opioids may cause serious problems for your baby, such as premature birth, drug withdrawal syndromes, stillbirth, congenital heart defects, neutral tube defects and other birth defects.

 

For more information on prescription drug misuse and abuse:

http://takemedsseriously.org
https://www.na.org